More on AF

AF is a complex and common form of cardiac arrhythmiaⁱ with a significant risk of morbidity and mortality. Current treatment options do not address this risk¹

Disease Burden

• Atrial fibrillation is a complex disease that double the risk of mortality²; increase the risk of strokeⁱ almost 5 fold³, worsens the prognosis of patients with CV risk factors^4,5

• There are several underlying factors which put patients at increased risk of developing AF including age, obesity, hypertension, myocardial infarction (MI), congestive heart failureⁱ (CHF) and valvular heart diseases⁶

• AF may adversely affects quality of life⁷

Economic Burden

• AF is the most common form of cardiac arrhythmia and currently affects nearly 7 million people in U.S. and Europe⁸ and is expected to double by 2050⁹

• Two studies published in 2006 demonstrated that atrial fibrillation was the leading cause of hospitalisation for arrhythmia in the U.S. and represented one-third of hospitalisations for arrhythmia in Europe^10,11

•  In the US, AF hospitalisations have increased dramatically in recent years (X2 to 3) Wattigney WA, Circulation. 2003;108:711-716

• Danish study demonstrated that, for the past 20 years, hospital admissions for AF have increased by 60 percent due to the ageing population, a rising prevalence of chronic heart disease and other factors ^12,13 

• 70 percent of annual cost of AF management in Europe is driven by hospitalization care and interventional procedures¹⁴

• In 2003, the COCAF study showed that 52 percent of cost of care for AF patients in France is linked to hospitalisation.

Medical Burden

• Drug therapy constitutes the main first line treatment choice in AF management. Antiarrhythmic drugs (AADs) are widely used for the conversion and long-term suppression of AF, despite the fact that current agents may have limited efficacy, poor tolerability and potential for serious ventricular proarrhythmia and/or organ toxicity.¹⁵

• None of the existing antiarrhythmic drug has ever shown any benefits in reducing morbidity or mortality in AF patients.

1. Hohnloser/NEJM/Effect of Dronedarone on Cardiovascular Events in AF/P11/Col 1/Lines 1-21
2. Benjamin/Circulation/Impact of AF on the Risk of death / P946 / Abstract / Lines A13-A14
3. Lloyd-Jones/Circulation/Lifetime Risk for Development of AF/P1044/Col 2/Lines 24-25
4. ACC/AHA/ESC/Circulation/2006 Guidelines/P20/Paragraph 1/Lines 2-5
5. Wachtell/JACC/Angiotensin II Receptor Blockade Reduces New-Onset AF/P716/Col 2/Paragraph 2/Lines 9-12
6. Benjamin EJ et al, Prevention of atrial fibrillation: report from a national heart, lung, and blood institute workshop. Circulation 2009; 119(4): 606-618
7. Dorian P et al. J Am Coll Cardiol. 2000;36:1303-1309
8. ACC/AHA/ESC/Circulation/2006 Guidelines/P19/Paragraph 3/Lines 21-22
9. Miyasaka/Circulation/Secular Trends in Incidence of AF/P123/Figure 2
10. Singh SN et al. J Am Coll Cardiol. 2006;48:721-730
11. Fuster V et al. ACC/AHA/ESC Guidelines. European Heart Journal 2006;27:1979–2030
12. Revised ACC/AHA/ESC Guidelines on atrial fibrillation recommend new approach. Stroke risk should determine anti-clotting treatment for people with irregular heartbeat. Available at: http://www.acc.org/qualityandscience/clinical/guidelines/atrial_fib/pdfs.... Last accessed: 05 November 2008
13. Friberg J, Buch P, Scharling H, et al. Rising rates of hospital admissions for atrial fibrillation. Epidemiology 2003;14:666–72
14. Ringborg/Europace/Costs of AF/P1/Col 1/Lines 24-29
15. Doggrell SA, Hancox JC. Dronedarone: an amiodarone analogue. Expert Opin Investig Drugs. 2004; 13: 415-26.